Psychological Disorders

Transcription

1 Consider: Psychological Disorders Chapter 14 List all the disorders you know (clinical names if possible) What movies, books, TV shows (etc.) have you seen that portray clinical disorders? What makes psychological disorders abnormal? What is abnormal? What is normal? Characteristics Statistical deviance Cultural deviance Emotional distress Dysfunction; maladaptive behavior Psychological disorder as an illness Medical model Biological, cognitive, social, and cultural factors Labeling effects and Rosenhan et al. (1973) study How long until doctors recognize ptnts aren t abnormal? Classification of disorders DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders 4 th Ed w/ revisions Five axes: Axis I: clinical disorders Axis II: personality disorders Axes III V: medical conditions, environmental problems, global functions Terminology Diagnosis Prognosis Etiology: cause of an illness Epidemiology: prevalence (pp458) 1

2 Psychological disorders Anxiety disorders Anxiety disorders Somatoform disorders Disorders of mood Dissociative disorders Schizophrenia Personality disorders Generalized anxiety disorder Feeling of chronic, excessive apprehension Not tied to one specific threat Physical symptoms Panic disorder Specific intense fear w/o realistic danger Recurrent: Interferes with everyday behavior Panic attacks: unexpected and feared Anxiety disorders Specific phobic disorder Animals spiders Locations heights Social situations Agoraphobia Fear of going out to public Phrenophobia: Fear of going crazy Epidemiology: Portion of population reporting each phobia (%) Tunnel or bridges Public transport Eat in public Public speak Closed places Storms Water Heights Bugs, snakes, bats

3 Obsessive-compulsive disorder Obsessions: thoughts Compulsions: actions Rituals to temporarily relieve anxiety Hand-washing Locking door Prevalence: Anxiety: 17% OCD: 2.5% with_ocd/ Eating disorders Anorexia nervosa Weighs 85% or less of normal weight Denies dangers of low weight Terrified of becoming fat Can also have depression, anxiety, withdrawal, OCD Bulimia Nervosa Binge-purge cycles Can have normal body weight Prevalence Anorexia: 1% (only 10% of people with anorexia are male) Bulimia: 4% Newsweek headline 11/05 Fighting Anorexia: No One to Blame The age of their youngest patients has slipped to 9 years old, and doctors have begun to research the roots of this disease. Anorexia is probably hard-wired, the new thinking goes, and the best treatment is a family affair. Somatoform disorders Somatization disorder History of physical complaints Appear to be psychological origin Conversion disorder Paralysis or weakness No clear physical cause and no correspondence to neural substrate Glove anesthesia Hypochondriasis Excessive concern over disease 3

4 Disorders of mood E.g.: Abraham Lincoln, Marilyn Monroe, Ernest Hemingway, Winston Churchill, Janis Joplin, Leo Tolstoy Major depressive episode Persistent feeling of sadness and despair Loss of interest in previous source of pleasure Changes in weight, sleep, activity, energy, concentration Bipolar disorder Depression plus manic state Prevalence: Depression: 7 to 17% Bipolar: 1%+ ple_with_major_depressive_disorder Vincent Van Gogh 4

5 Etiology of mood disorders Twin studies: Concordance rates Identical twins: 67% Fraternal twins: 15% Neurochemical factors Norepinephrine Serotonin Cognitive factors Learned helplessness Rumination of negative thoughts Dissociative disorders Loose contact with portion of consciousness resulting in disrupting sense of identity Dissociative amnesia Loss of memory for personal information Dissociative fugue Dissociative amnesia with flight or escape Dissociative identity disorder Coexistence of different personalities Usually unaware of multiple personalities Each personality has own name, traits, and behaviors E.g.: Dr. Jekyll & Mr. Hyde; Sybil Picture of movie Sybil Dissociative identity disorder Dissociative identity disorder Is it a legitimate disorder? Co-occurs with other disorders Origin unknown Able to be faked Research support for existence: Differences in optical tests with distinct personalities! 5

6 Schizophrenia Distorted thought and perception Symptoms Delusions and irrational thought Deterioration in routine functioning Hallucinations Disturbed emotion Categories of symptoms Positive: added Negative: removed Prevalence: 1 to 1.5% (1 out of 100 people!) Types of schizophrenia Paranoid type Delusions of grandeur, persecution, and jealousy Catatonic type Frozen or rigid posture Extreme resistance Disorganized type Inappropriate behavior and emotions Incoherent language Undifferentiated type Mix of other types Paranoid Schizophrenia Schizophrenia John Hinckley, Jr.: attempted to assassinate President Reagan To Jodi Foster: Over the past seven months I've left you dozens of poems, letters and love messages in the faint hope that you could develop an interest in me. Although we talked on the phone a couple of times I never had the nerve to simply approach you and introduce myself. [...] the reason I'm going ahead with this attempt now is because I cannot wait any longer to impress you. 6

7 Schizophrenia Schizophrenia Dopamine hypothesis Enlarged ventricles Loss of gray matter in frontal and parietal lobes Personality disorders Chronic, enduring pattern of behavior Anxious/fearful Dependent personality disorder Odd/eccentric Schizoid and schizotypal personality disorder Paranoid personality disorder Dramatic/impulsive Histronic and narcissistic personality disorder Borderline personality disorder Antisocial personality disorder 7

8 Antisocial personality disorder Psychopath or sociopath (previous terms) Disregard for rights of others Fail to conform to social norms/laws Repeated lying Impulsive Aggressive Reckless Lack of remorse Prevalence: 2 to 5% (5:1 male:female ratio) Other statistics: 80% abuse drugs and/or alcohol ~ 65-80% legal offenders have ASPD ASPD: Ted Bundy Hare s Psychopath Checklist Scoring: 0-absent; 1-maybe; 2-definitely there Interpersonal Superficial charm, grandiose, pathological lying, manipulative Affective Lacks remorse, shallow affect, callous, no responsibility Lifestyle Parasitic lifestyle, lacks goals, impulsivity, irresponsibility Antisocial Poor behavioral control, early juvenile delinquency Hollywood ASPD High intelligence Somewhat vein, stylish Successful Calm, calculating, in control 8

9 Etiology: ASPD Borderline personality disorder Twin concordance rates Identical: 50% Fraternal: 20% Neurochemical factor Testosterone Serotonin Brain functions: Frontal lobe Limbic system Social-Cognitive Rejection Harsh parenting Deficient arousal Low resting HR Slow EEG Less fear/anxiety Diminished startle Affect Depression Intense anger (quick mood shifts) Fear of abandonment Cognition Impaired perception of self Distorted thoughts: Magical thinking, omnipotence Impulsive Self-destructive behavior Substance abuse Sexual deviance Relationships Intense, unstable personal relationships Borderline personality disorder List of psychological disorders discussed Anxiety disorders Phobic disorders Obsessive-compulsive Eating disorders Anorexia Bulimia Dissociative disorders Dissociative amnesia Dissociative fugue Dissociative identity disorder Substance abuse disorders Somatoform disorders Conversion disorder Hypochondriasis Disorders of mood Major depression Bipolar disorder Schizophrenia Personality disorders Borderline personality disorder Antisocial personality disorder 9

10 Movies Beautiful mind Patch Adams What about Bob Memento Deuce Bigalow Girl interrupted As good as it gets Me, myself and Irene Clockwork Orange Mulholland Drive Secret Window Monk Heros House Law and Order CSI Lifetime tv MTV true life One who flew over the cockoo s nest 10